scholarly journals Laparoscopic surgery by spontaneous rupture of the esophagus, a case report of treatment Boerhaave syndrome

2020 ◽  
Vol 7 (10) ◽  
pp. 3442
Author(s):  
Eduard A. Galliamov ◽  
Igor V. Semenyakin ◽  
Sergey A. Erin ◽  
Evgeniy A. Kytirev ◽  
Grigorii Y. Gololobov ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Spontaneous Rupture ◽  
Positive Response ◽  
Response To Treatment ◽  
Esophageal Rupture ◽  
Invasive Approach ◽  
Perforation Hole ◽  
Spontaneous Esophageal Rupture ◽  
Somatic Status ◽  
Boerhaave Syndrome

Spontaneous rupture of the esophagus, Boerhaave syndrome, is a rare pathology and emergency condition for the patient. Patient, 63-year-old, on the 6th day of the disease falls into the clinic, where a Boerhaave syndrome was diagnosed. Laparoscopic surgery was performed. Sanitation and drainage of the mediastinum, suturing of the perforation hole were performed. After the operation, а positive response to treatment was observed. A group of authors believes that a minimally invasive approach to the treatment of spontaneous esophageal rupture is the alternative method for patients with severe somatic status and a small perforated opening of the esophagus.

P166 SPONTANEOUS ESOPHAGEAL RUPTURE – BOERHAAVE SYNDROME

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
B  Movchan ◽  
O Usenko ◽  
A Zgonnyk ◽  
R Vynogradov
Keyword(s):  
Spontaneous Rupture ◽  
Pleural Cavity ◽  
Clinical Manifestations ◽  
Esophageal Rupture ◽  
Esophageal Stents ◽  
Spontaneous Esophageal Rupture ◽  
Timely Diagnosis ◽  
Boerhaave Syndrome ◽  
Surgical Tactics ◽  
Effective Drainage

Abstract Aim To study the most effective method of treatment in patients with spontaneous rupture of the esophagus. Background The timely diagnosis of Boerhaave syndrome presents great difficulties due to its rarity, a variety of clinical manifestations, often simulating different pathologies from other organs and are difficult to treat. Methods From 2003 to 2019 9 patients with Bourhave's syndrome were treated at the clinic, primary care was provided to 6 patients in the community. All patients were admitted to the clinic with external left-sided esophageal-pleural fistula, 1 patient had a spontaneous rupture of the esophagus in the cliniс, the defect of the esophagus wall defect was completed, which led to successful results. Results Treatment in the remaining patients was started with adequate enteral nutrition and effective drainage of the pleural cavity. As a result of the use of pleural double-lumen drainage with active sanation with antiseptics and subsequent aspiration, with the exception of feeding through the mouth in four patients, it was possible to eliminate the esophageal-pleural fistula, profuse bleeding and death of the patient. Against the background of ongoing conservative therapy in two patients, it was not possible to eliminate the esophago-pleural fistula. A left-sided thoracotomy was performed with excision of the fistula with the decortication of the lung and the extirpation of the esophagus with the formation of an esophagostomy. Subsequently, these patients underwent retrosternal colic esophagoplasty. Two patients underwent Lewis surgery with drainage of the pleural cavity. Conclusion Boerhaave syndrome has a very high mortality rate, however, with a timely diagnosis and adequate surgical tactics, it develops into the formation of an esophageal-pleural fistula. In this case, the most effective treatment is excision of the fistulous course with extirpation of the esophagus and subsequent esophagoplasty. The use of esophageal stents is possible in extremely depleted patients or in elderly patients, due to the frequent occurrence of hypergranular esophagitis. Esophageal stents should be removed as soon as possible when confidence in the elimination of the esophageal-pleural fistula occurs.

scholarly journals Recurrent, Spontaneous Esophageal Ruptures Associated With Antiphospholipid Antibody Syndrome: Report of a Case

2014 ◽  
Vol 99 (6) ◽  
pp. 842-845 ◽  
Author(s):  
Hiroshi Naitoh ◽  
Minoru Fukuchi ◽  
Shinsuke Kiriyama ◽  
Takaharu Fukasawa ◽  
Yuichi Tabe ◽  
...  
Keyword(s):  
Spontaneous Rupture ◽  
English Literature ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Esophageal Rupture ◽  
Vascular Thrombosis ◽  
Spontaneous Esophageal Rupture ◽  
Increased Risk ◽  
Boerhaave Syndrome ◽  
Syndrome Report

Abstract A 52-year-old man was admitted to our hospital with a spontaneous esophageal rupture (Boerhaave syndrome) and was successfully treated. Eight years after the first incident, he was readmitted with a recurrent rupture. Recurrence of Boerhaave syndrome is extremely rare, with only 7 cases reported in the English literature. During treatment, the patient was also diagnosed with antiphospholipid syndrome (APS). Although APS is known to cause a variety of symptoms due to vascular thrombosis, recurrence of Boerhaave syndrome, coincident with APS, has never been reported. The pathogenesis of Boerhaave syndrome has not been clearly determined. This report serves to increase awareness of the risk of APS, which results in an increased risk of spontaneous rupture of the esophagus.

scholarly journals Results of treatment for Boerhaave syndrome

2019 ◽  
Vol 27 (1) ◽  
pp. 66-74
Author(s):  
Aleksey V. Mikheev ◽  
Sergey N. Trushin
Keyword(s):  
Primary Care ◽  
Surgical Treatment ◽  
Spontaneous Rupture ◽  
Surgical Intervention ◽  
Esophageal Rupture ◽  
Results Of Treatment ◽  
Boerhaave Syndrome ◽  
The Moment ◽  
Suture Failure

Background. Spontaneous rupture of the esophagus (Boehaave syndrome, BS) is a rare pathology in the surgical practice. Esophageal rupture makes no more than 2-3% of all cases of damage to the esophagus and is associated with a significant number of diagnostic errors and with high mortality. Aim. The aim of the study was to analyze the quality of diagnostics and the results of treatment of patients with spontaneous rupture of the esophagus. Materials and Methods. We performed a retrospective analysis of medical histories and of treatment results of 10 patients with Boerhaave syndrome hospitalized in the department of thoracic surgery of the Ryazan Regional Clinical Hospital, Ryazan in 2007-2018. Results. Four of ten patients were transferred from other medical institutions. At the primary care stage six patients were misdiagnosed; two of them underwent diagnostic laparoscopy for suspicion of acute pancreatitis and perforated gastric ulcer. The average time from the onset of the disease to surgery was 71.723.4 hours. Closure of the esophageal perforation was performed in all cases. Regarding the timing of surgery, all patients with Boerhaave syndrome were divided into 2 groups: patients with early intervention (4 patients operated within 24 hours); patients with late intervention (5 patients operated after 48 hours from the onset of the disease). One patient underwent surgical treatment within 24 hours in a medical facility outside the Ryazan region. In nine out of ten patients the rupture was localized in a typical place in the lower third of the esophagus along the left lateral wall. In the postoperative period eight patients had complete or partial esophageal suture failure, which required prolonged inpatient treatment (54.712.1 days). Postoperative mortality was 10% (1 patient of 10) and was caused by the progressive multi-organ failure and the development of cerebral ischemic stroke. Conclusion. The quality of diagnostics of Boerhaave syndrome remains unsatisfactory: due to rare occurrence of this pathology, most specialists of primary care settings, including surgeons, are not well acquainted with the etiopathogenesis and peculiarities of clinical presentation of Boerhaave syndrome. Diagnostic and treatment errors in rendering primary medical assistance reaches 60%. Results of surgical treatment directly correlate with the time from the moment of perforation and development of septic complications. Even with early surgical intervention performed within 24 hours from the moment of perforation, esophageal suture failure may occur in up to 75% of cases. Thus, the success of treatment is determined by early diagnosis, timely hospitalization in a specialized facility, and adequate surgical intervention.

scholarly journals INNOVATIVE DIAGNOSTIC METHODS FOR THE TREATMENT OF PATIENTS WITH BOERHAAVE SYNDROME AND ITS COMPLICATIONS

2021 ◽  
Vol 21 (4) ◽  
pp. 48-53
Author(s):  
К. G. Kubachev ◽  
В. A. Apereche ◽  
S M. Babaev
Keyword(s):  
Spontaneous Rupture ◽  
Diagnostic Methods ◽  
Vacuum Therapy ◽  
Esophageal Rupture ◽  
Treatment Results ◽  
Improve Treatment ◽  
Boerhaave Syndrome ◽  
Esophageal Stenting

Transluminal endoscopic interventions in the treatment of patients with spontaneous rupture of the esophagus can significantly improve treatment results. Esophageal stenting and vacuum therapy for the treatment of esophageal rupture and suture incompetence are alternatives to surgery.

scholarly journals Acute Respiratory Failure in a Patient With Spontaneous Esophageal Rupture (Boerhaave Syndrome)

2011 ◽  
Vol 56 (3) ◽  
pp. 347-350 ◽  
Author(s):  
P. Korczynski ◽  
R. Krenke ◽  
A. Fangrat ◽  
W. Kupis ◽  
T. M. Orlowski ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Esophageal Rupture ◽  
Spontaneous Esophageal Rupture ◽  
Boerhaave Syndrome

scholarly journals A New Method of Boerhaave Syndrome Surgical Treatment and Its Experimental Justification

2018 ◽  
Vol 11 (3) ◽  
pp. 193-201
Author(s):  
Md all Rayhan ◽  
Viktor Viktorovich Bulynin ◽  
Alexander Ivanovich Zhdanov ◽  
Yuri Alexandrovich Parkhisenko ◽  
Borich Efimovich Leibovich
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pleural Cavity ◽  
Operation Time ◽  
Esophageal Wall ◽  
Time Interval ◽  
Esophageal Rupture ◽  
Spontaneous Esophageal Rupture ◽  
Boerhaave Syndrome ◽  
Experimental Justification

Relevance. Spontaneous esophageal rupture (Boerhaave syndrome) is observed relatively rare ranging from 2.9% to 12% of all cases of damage of the esophagus. Today, there is not any categorical opinion about the effectiveness of different treatments among surgeons, there are not any single algorithms for the diagnosis and evaluation of treatment. Spontaneous esophageal rupture is a real threat for the life of patient: mortality up to 75% in the prehospital period and more than 90% in the postoperative period, and depends on the time interval between the rupture of the esophageal wall and the operation time, and also complications (suppurative esophagitis, suppurative mediastinitis, bilateral suppurative lobular pneumonia, sepsis). Purpose. To improve results of surgical treatment of patients with spontaneous esophageal rupture using the results obtained in the experiment. Materials and methods. Since 2004 till 2017 twelve patients with spontaneous esophageal rupture were treated in our hospital. Ways of treatment of lower third of esophageal rupture: drainage of pleural cavity – 2 patients; closure of the defect, fundoplication with covered stitches by the bottom of the stomach – 2 patients; perforated hole was not sutured, and a cuff, covering the perforation, was formed from the bottom of the stomach (fundoplication by Chernousov) – 8 patients. These methods of surgical treatment were applied in the experiments on 120 rats. Each group consisted of 40 rats. Results and discussion. The pleural cavity drainage, lethality – 1 (50%) patient. The suturing of the defect of the esophageal walls, the fundoplication with the stitches, covered by the bottom of the stomach, failure of stitches – 2 patients, lethality – 1 (50%) patients. The perforated hole was not sutured, and the cuff was shaped from the bottom of the stomach, covering the perforation. Lethality – 2 (25%) patients, caused by bilateral pneumonia in contrast to progressive sepsis. Other patients operated on this method didn’t have any failure of stiches. In the experiment: in the 1st group the failure of stitches was 87.5% and lethality – 100%; in the 2nd group the failure of stitches was 85% and lethality – 100%; in the 3rd group  there was not any failure of stitches, lethality – 17.5%. Conclusions. The most effective method of treatment is the restoration of rupture esophagus without suturing, and forming a cuff from the bottom of the stomach, covering the perforation. Drainage of pleural cavity and nutrition through a nasogastric tube.

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